Individual provider Active NPI

Scott Robert Witherspoon, MD

  • Retina Specialist (Ophthalmology) Physician
  • Dallas, TX
National Provider Identifier
1639203169
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
N2885 Issued in TX
Practice address
3414 Oak Grove Ave
Dallas, TX 75204-2375
Phone
(214) 521-1153
Fax
(214) 219-3651
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X N2885 TX
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X N2885 TX Primary

Addresses

Primary practice location

3414 Oak Grove Ave
Dallas, TX 75204-2375

Mailing address

3414 Oak Grove Ave
Dallas, TX 75204-2375
Phone (214) 521-1153

Other practice location 1

1010 E Interstate 20
Arlington, TX 76018-2107
Phone (817) 417-7769

Other practice location 2

400 W Lyndon B Johnson Fwy Ste 320
Irving, TX 75063-3717
Phone (972) 869-1242

Other practice location 3

3331 Unicorn Lake Blvd
Denton, TX 76210-0102
Phone (940) 381-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090720000307 TX Practitioner - Ophthalmology 2365535408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Saint Louis University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Institute of Texas PAGroup PAC ID 9234160581, 4 clinicians

Practice addresses (Care Compare)

400 W Interstate Hwy 635
Suite 320
Irving, TX 75063-3717
Phone (972) 869-1242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Quality
98.3
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N2885TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Institute of Texas PA Single Specialty Current Accepting new patients
Retina Institute of Texas PA Single Specialty CurrentSince Aug 1, 2009 Accepting new patients
Retina Institute of Texas PA Single Specialty CurrentSince Aug 1, 2009 Accepting new patients

Locations

1010 E Interstate 20
Arlington, TX 76018
Phone (817) 417-7769

3414 Oak Grove Ave
Dallas, TX 75204
Phone (214) 521-1153

3331 Unicorn Lake Blvd
Denton, TX 76210
Phone (940) 381-9100

400 W Lyndon B Johnson Fwy
Ste 320
Irving, TX 75063
Phone (972) 869-1242

Interoperability endpoints

  • Direct secure messaging: switherspoon@direct.uspi.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60285
  • Direct secure messaging: robert.witherspoon@riot.directbygreenway.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1639203169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 OAK GROVE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042375",
            "telephone_number": "214-521-1153",
            "fax_number": "214-219-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 OAK GROVE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042375",
            "telephone_number": "214-521-1153",
            "fax_number": "214-219-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 E Interstate 20",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760182107",
            "country_code": "US",
            "telephone_number": "817-417-7769",
            "fax_number": "817-417-7405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Lyndon B Johnson Fwy Ste 320",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750633717",
            "country_code": "US",
            "telephone_number": "972-869-1242",
            "fax_number": "972-869-2921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3331 Unicorn Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762100102",
            "country_code": "US",
            "telephone_number": "940-381-9100",
            "fax_number": "940-381-9106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "N2885",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "N2885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.